Mobilization and transplantation of autologous hematopoietic stem and progenitor cells from the blood

The use of peripheral blood progenitor cells instead of bone marrow to rescue hematopoiesis has dramatically reduced the morbidity and costs of high-dose chemo/radiotherapy. The time of aplasia after the myeloablative regimen is now only 8-14 days, reducing hospital stay and use of antibiotics and red cell or platelet transfusions. Sufficient progenitor and stem cells can be obtained with a small number of leukaphereses after mobilization in the blood by chemotherapy and hematopoietic growth factors or by growth factors alone. This method constitutes the treatment of choice for patients with relapse of Hodgkin's disease and of high-grade non-Hodgkin's lymphoma. Future developments will include the definition of new indications and the search for ways to eliminate tumor cells from the graft.